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Biologics in relapsing polychondritis: a case series
Guillaume Moulis1, Laurent Sailler, Grégory Pugnet
1Internal Medicine Department, Toulouse University Hospital, UMR INSERM-UPS 1027, University of Toulouse, Toulouse, France. guillaume.moulis@univ-tlse3.fr.
Clinical and Experimental Rheumatology
|September 12, 2013
Summary
Biologics, particularly TNF-antagonists, show efficacy in treating relapsing polychondritis, offering a corticosteroid-sparing option. Further prospective studies are needed to confirm the benefit-to-risk ratio of these treatments.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Relapsing polychondritis is a rare systemic autoimmune disease.
- Corticosteroids are the mainstay of treatment but have significant long-term side effects.
- Biologic therapies offer a potential alternative for managing relapsing polychondritis.
Purpose of the Study:
- To evaluate the efficacy and safety of biologic agents in patients with relapsing polychondritis.
- To describe the real-world effects of biologics as corticosteroid-sparing drugs.
Main Methods:
- Retrospective analysis of relapsing polychondritis cases.
- Diagnosis confirmed using Damiani's criteria.
- Evaluation of patients treated with biologics for efficacy and adverse events.
Main Results:
- Nine patients received 22 different biologics.
- TNF-antagonists were effective in 85.7% of first-line cases.
- Abatacept and tocilizumab showed efficacy as second-line treatments.
- Seven serious adverse events, including five infections, were reported.
Conclusions:
- TNF-α antagonists may be considered earlier in relapsing polychondritis treatment.
- Switching to alternative biologics is feasible upon loss of efficacy.
- Tocilizumab or abatacept can be considered for third-line therapy.
- Prospective evaluation of the benefit-to-risk ratio of biologics is warranted.
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